Upper Extremity Assessment in Stroke Patients

[Solala]

Hello, physios,

I have to make a research on upper extremity function rehabilitation in acute cerebral stroke. I am looking for tests and scales and information how to perform them and equipment needed

Some I am in need of are general, some are not as

1.Fugl-Meyer assessment scale

2. the ARA (Action research arm test)

3. Chedoke-McMaster Stroke Assessment

4. Brunnstrom

5. the Reaching Performance Scale

6. The Chedoke Arm and Hand Activity Inventory

7. Shoulder Shrug Test


Desperately need help!!!

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[irishneurohead]

Have you tried upper limb motor assessment scale (MAS)

[gcoe]

Hi Solala

There are actually a large number of measures available, some commercially available (so at often some considerable cost) and others that you can construct yourself. For some items you might need to make the items such as blocks etc.

You may find information and manuals for these tests on the web. Often you will need to go back to the original article to get the specifications. However you may want to refer to a good outcome measure texts. Such texts will give the full instructions, reference the original articles and research backing the test. That is a really good place to start to get the resources you need. Two invaluable texts are:

Elspeth Finch, Dina Brooks, Paul W Stratford, Nancy E Mayo Physical Rehabilitation Outcome Measures 2nd Ed - this is a Canadian text and is excellently put together

Amazon.com: Physical Rehabilitation Outcome Measures (Book with CD-ROM) (9780781742412): Elspeth Finch, Dina Brooks, Paul W Stratford, Nancy E Mayo: Books


The Australian Physiotherapy Association National Neurology Group also puts out a very good text. Email the association. It costs about AUD60.00

Home

Looking through your list there are some good ones there. However some are quite old and there are theoretically more sound instruments. In thinking about a measure you may want one that captures a number of different types of activities you want to sample:

reaching and grasping
manual handling
object manipulation
in hand manipulation

At an activity limitation level the most used upper limb outcome measures in our part of the world would probably be:

The upper limb scales of the Motor Assessment Scale (ULMAS) - activity oriented Australian scale

The Wolf Motor function test - an activity oriented upper extremity scale used developed for use in the Constraint-induced Movement Therapy studies.

There is also the Motor Activity Log (MAL) if you want to quantify how much activity and what types of activity patients engage in.

You mentioned the ARAT which is a good measure. The Jebsen Hand function test is also a good instrument.


You may also want to think about a manual dexterity test (hand manipulation/time). There are lots of these available but the 9 hole peg test and the Box and Block test are good examples.

At the impairment level the Upper limb scale of the Motricity Index for measuring strength could be useful and for you could use the Jamar for gross grip strength and the B&L for pincer grip strength - however these come at a cost.

As with any measure you will also need to consider the validity, reliability and responsiveness of the measures and whether you need normative data. these books will give you summary data on this.

Remember too that you are better to have one primary outcome measure (and only one or two extra ones) that has excellent utility, reliability, validity and responsiveness and measures exactly what you want to measure, then having a huge number of measures that are of dubious quality. Depending on your statistical analysis each additional measure increases the probability of type 1 errors in your findings.

Good luck with your research